The Courts

A federal judge said he hopes to rule on the legality of Medicaid work requirements in Arkansas and Kentucky by the end of the month, unveiling his plan to decide quickly at the conclusion of back-to-back court hearings Thursday (March 14) that tested the reasoning behind one of the Trump administration’s most controversial health care priorities.

Lawyers for Medicaid beneficiaries and the federal government will square off Thursday (March 14) for round two of the high-profile litigation over the legality of Medicaid work requirements—and the arguments they make likely will sound familiar.

A coalition of business groups and other stakeholders tell Senate health committee Chair Lamar Alexander (R-TN) and ranking Democrat Patty Murray (WA) that repealing the Affordable Care Act’s 40 percent tax on high-cost plans would be a critical first step in improving the health system, and also urge the lawmakers to reject any attempt to tax employer-sponsored coverage.

Republican Sen. Susan Collins (ME) joined a group of Senate Democrats and advocacy groups on Tuesday in expressing opposition to Sixth Circuit Court of Appeals nominee Chad Readler, arguing that Readler’s controversial refusal to fully defend the Affordable Care Act against a constitutional challenge while at the Justice Department disqualifies him from a promotion.

The government appealed a D.C. federal district court ruling that found CMS did not have authority to cut reimbursement for 340B drugs by almost 30 percent in 2018, but both the agency and the hospitals are asking to put the appeal on hold until the lower court makes a decision on how the situation should be rectified.

The coalition of groups suing to overturn the administration’s expansion of short-term plans is asking a federal judge to immediately rule in its favor, and the Department of Treasury, which is defending the plans, is also seeking a quick resolution.

The National Home Infusion Association is asking the federal DC district court to make CMS withdraw and rework its final rule setting interim home infusion payments, in a lawsuit filed Feb. 14.

The U.S. Court of Federal Claims handed issuers major wins in four cost-sharing reduction (CSR) cases, including a class action suit brought by Wisconsin’s Common Ground Health Cooperative in which Judge Margaret Sweeney ruled that the government is responsible for reimbursing plans unpaid CSRs in 2017 as well as in 2018, despite the silver-loading workaround. Sweeney issued that decision on Friday (Feb. 15), the same day she ruled in favor of Texas non-profit Community Health Choices and Maine Community Health Options.

Hospitals that sued CMS over cuts to reimbursement for 340B drugs are asking the court to make CMS recalculate payments to make up for those cuts, but the government says that would require all hospital outpatient payments be recalculated in order to keep the pay system budget neutral and tells the court to let CMS figure out how to fix the situation.